Maternal diabetes and risk of childhood cancer in the offspring

다국어 초록 (Multilingual Abstract)

An association between maternal diabetes, its medication and childhood cancer has not been previously explored in a registry‐based setting. With a case–control design, we aimed to explore whether maternal diabetes is associated with an increased risk of childhood cancer in the offspring. Combining data from population‐based registries, we analyzed a total of 2,029 cases, that is, persons with childhood cancer diagnosed under the age of 20 years between years 1996–2014 and a total of 10,103 matched population controls. The mothers of the cases/controls and their diagnoses of diabetes (DM) before/during pregnancy as well as their insulin/metformin prescriptions during pregnancy were identified. Conditional logistic regression modeling was used to analyze the risk of childhood cancer. The OR for childhood cancer among those exposed to any maternal diabetes was 1.32 (95% CI 1.14–1.54) compared to the offspring of the nondiabetic mothers. The effect of maternal diabetes on the risk of childhood cancer remained elevated even after adjusting for maternal age, parity and smoking. Our data suggest that maternal diabetes medication may reduce the risk for childhood cancer (adjusted OR 0.83, 95% CI 0.36–1.94), especially in gestational diabetes (adjusted OR 0.26, 95% CI 0.05–1.25), compared to the diabetic mothers without medication. The risk of childhood leukemia was significantly higher among children exposed to any maternal diabetes (OR 1.36, CI 1.04–1.77) compared to the unexposed. Maternal diabetes appears to be associated with an increased risk of childhood cancer in the offspring. The possible risk‐reducing effect of an exposure to diabetes medication on offspring cancer risk warrants further investigation.
What's new?
Only a small fraction of early‐onset childhood cancers are linked to hereditary factors, suggesting that perinatal exposures, particularly in the mother, significantly impact childhood cancer risk. A potentially important, though understudied risk factor is maternal diabetes. This investigation of nationwide population‐based registry data shows that maternal diabetes is associated with an elevated risk of childhood cancer in offspring. Offspring born to mothers diagnosed with gestational diabetes were at increased risk of childhood leukemia and certain solid tumors in particular. Further investigation is needed to determine whether diabetes medications taken during pregnancy can reduce cancer risk in offspring.